Revista medica del Instituto Mexicano del Seguro Social最新文献_第10页

[Report of 3 cases of acute hemorrhagic leukoencephalitis in Mexico]. [墨西哥 3 例急性出血性白脑炎病例报告]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-05 DOI: 10.5281/zenodo.10814411

Crhistian Alejandro Aguilar-Vázquez, Carlos César Reyes-Hernández, Julián Alberto Hernández-Domínguez, Alejandra Diana Raymundo-Carrillo, Elizabeth Damaris Flores-Vivaldo

{"title":"[Report of 3 cases of acute hemorrhagic leukoencephalitis in Mexico].","authors":"Crhistian Alejandro Aguilar-Vázquez, Carlos César Reyes-Hernández, Julián Alberto Hernández-Domínguez, Alejandra Diana Raymundo-Carrillo, Elizabeth Damaris Flores-Vivaldo","doi":"10.5281/zenodo.10814411","DOIUrl":"10.5281/zenodo.10814411","url":null,"abstract":"Background: Acute hemorrhagic leukoencephalitis (AHLE) or Weston-Hurst syndrome is a rare and severe variant of acute disseminated encephalomyelitis (ADEM). It causes fulminant hemorrhagic demyelination of the central nervous system, and has high mortality and morbidity. Due to the increase in cases and to its high rate of mortality, we decided to make a series of cases and a review of the disease.Clinical cases: We present 3 cases of Mexican patients, with clinical, radiological, and cerebrospinal fluid presentation compatible with the disease, with little response to treatment and high short-term morbidity. In 2 of the cases, there was positive evidence of aquaporin 4 antibodies (ac-AQP4), without any other apparent trigger.Conclusions: There is little evidence on the clinical evolution and medical management of the disease. With the arrival of the COVID-19 pandemic, there was an increase in cases of these diseases of autoimmune etiology. Although these cases did not present previous infection by COVID 19, there was an increase in the immunogenicity of ab- AQP4. Because of this, we believe it is important to distinguish it, describe as many cases as possible, and provide more information about its diagnosis, treatment, and prognosis. Likewise, we carried out a brief systematic review of the bibliography.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"62 suppl 2","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Survival after hematopoietic stem cell transplantation with identical and haploidentical donors]. [同卵和异卵供体造血干细胞移植后的存活率]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-05 DOI: 10.5281/zenodo.10814305

Marco Alejandro Jiménez-Ochoa, María Margarita Contreras-Serratos, Martha Leticia González-Bautista, Constantino López-Macías, Lourdes Andrea Arriaga-Pizano, Miriam Elizabeth Aguilar-Marquez

{"title":"[Survival after hematopoietic stem cell transplantation with identical and haploidentical donors].","authors":"Marco Alejandro Jiménez-Ochoa, María Margarita Contreras-Serratos, Martha Leticia González-Bautista, Constantino López-Macías, Lourdes Andrea Arriaga-Pizano, Miriam Elizabeth Aguilar-Marquez","doi":"10.5281/zenodo.10814305","DOIUrl":"10.5281/zenodo.10814305","url":null,"abstract":"Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is a therapy that offers the potential to cure hematological malignancies. One limitation is that only 25% of patients will have an identical donor. The use of haploidentical donors allows 95% of patients to have a donor. Experience in Mexico with haploidentical HSCT is limited. In 2018, the Haploidentical Transplantation Program began at the Hospital de Especialidades (Specialties Hospital) from the Centro Médico Nacional Siglo XXI (21st Century National Medical Center).Objective: To compare the overall survival of patients undergoing HSCT with an identical or haploidentical donor at the Hospital de Especialidades.Material and methods: A retrospective, observational study was carried out in patients undergoing HSCT at the Hospital de Especialidades, from January 2018 to December 2022. All patients who received HSCT were included. Overall survival analysis was performed using Kaplan-Meier curves. A significance level of p < 0.05 was considered.Results: 109 patients who underwent to allogeneic HSCT were analyzed, 34% of them had a haploidentical donor. There were no differences in overall survival. The haploidentical group presented greater cytomegalovirus reactivation and less chronic graft-versus-host disease (GVHD).Conclusions: No differences in survival were found in both groups, which is why haploidentical transplantation could be a good treatment option in patients who do not have an identical donor at our institution.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"62 suppl 2","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Translational medicine in dermatology: experience in the Specialties Hospital of the 21st Century National Medical Center]. [皮肤科转化医学：21 世纪国家医疗中心专科医院的经验]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-05 DOI: 10.5281/zenodo.10814393

Elizabeth Michel Ortega-Rocha, Brenda Hernández-Rico, Laura Cecilia Bonifaz-Alfonzo, Alicia Lemini-López

{"title":"[Translational medicine in dermatology: experience in the Specialties Hospital of the 21st Century National Medical Center].","authors":"Elizabeth Michel Ortega-Rocha, Brenda Hernández-Rico, Laura Cecilia Bonifaz-Alfonzo, Alicia Lemini-López","doi":"10.5281/zenodo.10814393","DOIUrl":"https://doi.org/10.5281/zenodo.10814393","url":null,"abstract":"Through multidisciplinary research, translational medicine allows a comprehensive approach to diseases in order to provide patients with adequate treatment, whose aim is personalized and precision medicine. In this context, the Cellular Immunology Laboratory of the Immunochemistry Research Unit, and the Dermatology Service of the 21st Century National Medical Center's Specialties Hospital (Hospital de Especialidades del Centro Médico Nacional Siglo XXI) have achieved a partnership that aspires to provide better quality patient care. This objective is achieved by evaluating the inflammatory skin infiltrates in different pathologies to observe changes in local immunity related to the response to treatment, and with the disease progression distinguish between dermatological diseases, highlight the importance of comprehensive skin care, and make decisions about treatment choice. This article will describe the results obtained from different research protocols (derived from this collaboration) in patients with different dermatoses such as warts, squamous cell carcinoma, mycosis fungoides and psoriasis. The evidence presented highlights the importance of collaborative work between clinical services and research laboratories so that scientific knowledge can be translated towards the comprehensive management of patients and towards personalized and precision medicine.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"62 suppl 2","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[The Specialties Hospital of the 21st Century National Medical Center: 60 trailblazing years in Mexican medicine]. [21 世纪国家医疗中心专科医院：墨西哥医学的 60 年辉煌历程]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-05 DOI: 10.5281/zenodo.10814287

Francisco José Avelar-Garnica

引用次数: 0

[Occult thyroid dysfunction in outpatients with liver cirrhosis]. [肝硬化门诊患者隐匿性甲状腺功能障碍]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-05 DOI: 10.5281/zenodo.10814357

Nayeli Ortiz-Olvera, Araceli Muñoz-Bautista, Mario Molina-Ayala, Rita A Gómez-Díaz, Segundo Morán-Villota

{"title":"[Occult thyroid dysfunction in outpatients with liver cirrhosis].","authors":"Nayeli Ortiz-Olvera, Araceli Muñoz-Bautista, Mario Molina-Ayala, Rita A Gómez-Díaz, Segundo Morán-Villota","doi":"10.5281/zenodo.10814357","DOIUrl":"https://doi.org/10.5281/zenodo.10814357","url":null,"abstract":"Background: Several alterations in thyroid function have been identified in patients with liver cirrhosis (LC).Objective: To carry out a thyroid disease screening in adult patients with LC.Material and methods: A cross-sectional study. Serum levels of thyroid-stimulating hormone (TSH) and free-tetraiodothyronine (T4) were measured, and compared according to etiology of the cirrhosis, sex, model of end-stage liver disease (MELD) score, and Child-Pugh (C-P) class.Results: The most frequent etiology was hepatitis C virus (45%), followed by non- alcoholic fatty liver-disease (17%). We found thyroid dysfunction in 36% of the patients. The most frequent alteration was subclinical hypothyroidism (34%). Patients with alcohol-induced cirrhosis had the highest frequency of subclinical hypothyroidism (45%) and TSH levels were higher in patients with cirrhosis due to autoimmune disease and in those with alcohol-induced cirrhosis.Conclusion: We found no correlation between thyroid hormone levels, age, MELD score, or C-P. Our results showed that occult primary thyroid dysfunction is frequent in outpatients with LC, regardless of age, etiology, or liver reserve. Subclinical hypothyroidism was the main alteration and presented more frequently in patients with alcohol-induced cirrhosis. Longitudinal studies are needed to know the impact of subclinical hypothyroidism on the clinical progression of patients with cirrhosis.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"62 suppl 2","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Gastrointestinal manifestations and liver disorders in patients with COVID-19]. [COVID-19患者的胃肠道表现和肝功能紊乱]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-05 DOI: 10.5281/zenodo.10814332

Elmer Vázquez-Cruz, Jorge Alonso Garay-Ortega, Aleida Bautista-Santos, Rosalba Moreno-Alcántar

{"title":"[Gastrointestinal manifestations and liver disorders in patients with COVID-19].","authors":"Elmer Vázquez-Cruz, Jorge Alonso Garay-Ortega, Aleida Bautista-Santos, Rosalba Moreno-Alcántar","doi":"10.5281/zenodo.10814332","DOIUrl":"10.5281/zenodo.10814332","url":null,"abstract":"Background: SARS-CoV-2 infection began in Wuhan, China, in December 2019, where the first cases of pneumonia were described. The infection spread rapidly and was established as a pandemic by the World Health Organization (WHO) in February 2020. In Mexico, the first cases were in March 2020. Although the classic symptoms are respiratory, gastrointestinal symptoms have been described in 17%, as well as hepatic disorders associated with pneumonia.Objective: To describe the gastrointestinal manifestations and hepatic alterations in patients with COVID-19 from July 2020 to January 2021 in a tertiary-care hospital.Material and methods: Clinical, cross-sectional, prolective, observational, analytical study, which included patients of 18 years or older hospitalized with COVID-19, confirmed by PCR for SARS-CoV-2.Results: 84 patients were included, 65% male (55). Mean age was of 59 (± 13.3) years. Reported comorbidities were systemic arterial hypertension (51%), type 2 diabetes (38%), and obesity (26%). The predominant pattern was hepatocellular with elevation of AST (38) 45%, ALT (36)42%, GGT (30) 34% and FA (11) 13%. The prevalence of gastrointestinal symptoms was 71% (60/84), with diarrhea being the most frequent 53% (4 bowel movements/day) and dysgeusia (36.9%). There were 12 patients (10.02%) who presented diarrhea as the initial symptom with respiratory complications 5-7 days later.Conclusions: Gastrointestinal and hepatic manifestations occurred in 71% of the patients.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"62 suppl 2","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[21st National Medical Center's Specialties Hospital: 60 years at the forefront of medicine in Mexico]. [第 21 国立医疗中心专科医院：60 年来一直走在墨西哥医学前沿]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-05 DOI: 10.5281/zenodo.10814249

Natividad Neri-Muñoz

引用次数: 0

[Risk assessment for complications and stone free status in percutaneous nephrolithotomy]. [经皮肾镜取石术并发症和无结石状态的风险评估]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-05 DOI: 10.5281/zenodo.10814377

Jorge Moreno-Palacios, Efraín Maldonado-Alcaraz, Rodolfo Rivas-Ruiz, Romina Vega-Hermosillo, Virgilio Augusto López-Sámano

{"title":"[Risk assessment for complications and stone free status in percutaneous nephrolithotomy].","authors":"Jorge Moreno-Palacios, Efraín Maldonado-Alcaraz, Rodolfo Rivas-Ruiz, Romina Vega-Hermosillo, Virgilio Augusto López-Sámano","doi":"10.5281/zenodo.10814377","DOIUrl":"https://doi.org/10.5281/zenodo.10814377","url":null,"abstract":"Background: Percutaneous nephrolithotomy (PNL) is the first line treatment for kidney stones with a diameter > 2 cm. The available scores for measuring success in this procedure only consider the free stone status, without considering the complications.Objective: To present a new prognostic stratification system to predict treatment failure in PNL.Material and methods: Historic cohort in which prognostic factors and failure as residual stone with or without complication were identified. A bivariate analysis was performed using the numeric variables and with the use of conjunctive consolidation a prognostic stratification system was developed.Results: A total of 595 cases were included, out of which 73% concluded with free stone status and 12% developed major complications. 66% fulfilled the proposed success definition. In the first conjunct consolidation, a positive urine culture and a complex stone were identified as risk factors; after making one more conjunction with another stratum, the severe Charlson Comorbidity Index (CCI) was also identified as a risk factor. Finally, an operating time ≥ 120 minutes was added as an intraoperative factor that increases risk.Conclusions: The variables positive urine culture, severe CCI, complex stone and prolonged operating time are associated with major complications and residual stone. The proposed score is a simple and predictive tool that can be used in daily practice, given that it includes 3 pre-operative variables. The treatment success or failure rate of the score can be applied in the selection of patients ongoing PNL.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"62 suppl 2","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Predictive factors for MASLD in type 2 diabetes: 1 year follow-up study]. [2 型糖尿病 MASLD 的预测因素：1 年随访研究]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-05 DOI: 10.5281/zenodo.10814344

Niels H Wacher, Rita A Gómez-Díaz, Adriana L Valdez-González, Ximena Duque-López, Segundo Morán-Villota, Rafael Mondragón-González, Miguel Cruz-López, Víctor H Borja-Aburto

{"title":"[Predictive factors for MASLD in type 2 diabetes: 1 year follow-up study].","authors":"Niels H Wacher, Rita A Gómez-Díaz, Adriana L Valdez-González, Ximena Duque-López, Segundo Morán-Villota, Rafael Mondragón-González, Miguel Cruz-López, Víctor H Borja-Aburto","doi":"10.5281/zenodo.10814344","DOIUrl":"https://doi.org/10.5281/zenodo.10814344","url":null,"abstract":"Background: It has been proposed the current nomenclature for metabolic dysfunction-associated steatotic liver disease (MASLD) as a general term to encompass the various etiologies of steatosis and to include the presence of at least 1 of 5 cardiometabolic risk factors.Objective: To evaluate the predictors of the incidence of MASLD in patients with type 2 diabetes (T2D) in primary care at a one-year follow-up.Material and methods: Prospective cohort study including patients (n = 5143) with ≤ 15 years from diagnosis of T2D, treated at primary care units in Mexico City and metropolitan area. At baseline and at one-year follow-up were measured: anthropometry, HbA1c, microalbuminuria, creatinine, lipid profile and hepatic markers aspartate aminotransferase and alanine aminotransferase (ALT). Hepatic Steatosis Index (HSI) and Lipidic Accumulation Product (LAP) were calculated. MASLD was considered as cases with abnormal ALT.Results: At baseline, 1449 (28.2%) patients presented MASLD. The HSI and LAP indices were higher in MASLD. Age at diagnosis and time of exposure to T2D were inversely associated with MASLD, and directly proportional to body mass index, waist circumference (WC) and HbA1c. Of the cases with MASLD at baseline, 452 (38.8%) reverted to normal and 712 (61.2%) persisted after follow-up. ORs for MASLD were 1.86 and 1.88 for HbA1c and WC, respectively.Conclusions: The combination of HSI, LAP and screening with HbA1c and WC are useful to identify MASLD in patients with T2D.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"62 suppl 2","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Organizational culture: The influence of leadership in improving institutional health processes]. [组织文化：领导力对改善机构健康流程的影响]。

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2024-09-02 DOI: 10.5281/zenodo.12668107

Montserrat Legorreta-Rojas, Ulises Trejo-Amador

{"title":"[Organizational culture: The influence of leadership in improving institutional health processes].","authors":"Montserrat Legorreta-Rojas, Ulises Trejo-Amador","doi":"10.5281/zenodo.12668107","DOIUrl":"https://doi.org/10.5281/zenodo.12668107","url":null,"abstract":"The prevailing administrative and managing culture of health services in Mexico is questionable. The people in charge of health systems and medical units of the 3 levels of care, also called leaders, by making decisions with little or no preparation and also weak information systems, forcefully nullify any pretensions to making better quality decisions, all of which affects both the user population, and health personnel. If these leaders are improvised, emergent or simply do not have the required preparation, they make it difficult to achieve objectives or goals or they even do not have an organizational climate that favors teamwork. Currently there is a discussion about types of leadership and their characteristics. The COVID-19 pandemic showed us that leaders face challenges and they must be prepared to make objective decisions that benefit both the worker and the population; they must be capable of facing new challenges that allow them to grow and prosper among their collaborators and consequently all the staff. There are some differences in public and private institutions, but leadership is applied in both cases with its particularities. Currently, the delivery of courses, workshops and even postgraduate degrees on issues of leadership and organizational climate provide tools to strengthen these people.","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"62 5","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0